IndividualActive
Manny Kelly, LPT
NPI 1003479320 · Licensed Psychiatric Technician · San Bernardino, CA
Provider details
- NPI number
- 1003479320
- Entity type
- Individual
- Primary specialty
- Licensed Psychiatric TechnicianNursing Service Providers
- Credential
- LPT
- Sex
- Male
- Sole proprietor
- Yes
- License
- 33817 (CA)
Specialties & taxonomies
Nursing Service Providers
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1481 Windsor Dr
San Bernardino, CA 92404-5416
Phone: (909) 361-6472
Fax: (909) 203-7403
Street-level locationGet directions
Mailing address
2895 W Fairview Dr
Rialto, CA 92377-3425
Registry dates
- Enumerated
- 2019-04-22
- Last updated
- 2019-04-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.